n this luminous debut memoir, a woman struggles to care for her Alzheimer’s-stricken mother, experiencing exhaustion, heartache, moments of joy, and a renewed connection to her loved ones.

Kincaid, an only child who never married, spent a decade caring for her mother, Dixie Garrett Kincaid, after she began suffering from dementia, eventually taking her into her own Arlington, Virginia, home. As the disease progressed from forgetfulness to eccentricity to a loss of reason, self-control, and language, the author found herself becoming a parent to her mother, whom she often characterizes as being as helpless and demanding as an infant, yet big and mobile enough to cause chaos. Kincaid is unsparing about the realities of Alzheimer’s care, describing her mother’s hygiene problems and violent outbursts; her sometimes-charming, sometimes-infuriating habit of hiding clothes and household objects; and her recurrent medical emergencies, exacerbated by her inability to explain what was wrong. The author also describes her own sleep deprivation and her feelings of intense guilt when she had to deposit her mother in respite care to let herself recuperate. She cogently criticizes the nationwide Alzheimer’s-care network for its frequent lapses and callousness, castigates doctors for making cavalier treatment decisions without considering her mother’s circumstances, and accuses a nursing facility of making false medical claims to justify sending her mother back to the hospital. The author’s wrangles with HMO doctors to get treatment for her own serious ailments, including breast cancer, constitute an appalling health care horror story of its own. But there are also rewards here: her mother’s once-difficult temperament improves as she experiences happiness, satisfaction, and episodes of clarity, and Kincaid’s caregiving results in a deeper familial bond. The author sets the story of her care against description of her fraught relationship with her mother before her decline, and of the strong, inspirational women in her extended family. In vivid, graceful prose, she offers an honest account of the burdens of Alzheimer’s patients without losing sight of their importance in the lives of those who care for them.

A cleareyed, moving portrait of Alzheimer’s and the family ties that transcend it.